Supplementation of nano-selenium (SeNPs) improved growth, immunity, antioxidant enzyme activity, and selenium retention in broiler chicken during summer season.

The present experiment was aimed at finding the optimal supplemental dose of nano-selenium in broiler chicken during the summer season for better performance in terms of growth, blood metabolites, immune response, antioxidant status, and selenium concentration in vital organs. Three-hundred-day-old Vencobb broiler chicks were randomly distributed into five dietary treatment groups with six replicates of 10 chicks each. The dietary treatments were as follows: T1 (control group), basal diet; T2, basal diet with 0.0375 ppm of nano-Se; T3, basal diet with 0.075 ppm of nano-Se; T4, basal diet with 0.15 ppm of nano-Se; T5, basal diet with 0.3 ppm of nano-Se. The experiment was carried out for 35 days. The average gain and feed conversion ratio were best observed in T4 and T5. The antibody titres were significantly higher (P < 0.05) in the treated birds. At the 5th week, erythrocytic glutathione peroxidase, catalase, and superoxide dismutase activities were significantly (P < 0.05) higher and lipid peroxidation values were significantly (P < 0.05) lower in all the nano-Se-treated groups. The Se levels in the liver, breast muscle, kidney, brain, and gizzard were significantly (P < 0.05) increased with increased dietary nano-Se. Histological studies of the liver and kidney in the highest nano-Se-treated groups (T4 and T5) did not show any abnormal changes. It is concluded that supplementation of nano-selenium at 0.15 ppm over and above the basal level improved the performance and protect the birds from summer stress without any adverse effect on the vital organs of chicken.

Role of postoperative intact serum PTH as an early predictor of severe post-thyroidectomy hypocalcemia: a prospective study.

BACKGROUND: Post thyroidectomy hypocalcemia is a major sequel of thyroidectomy and continues to trouble the endocrinologists and the endocrine surgeons as there is no ideal predictive marker of hypocalcemia which has the potential to develop into a life-threatening complication. The role of early serum intact parathormone (iPTH) to predict post thyroidectomy hypocalcemia is becoming useful but the literature is still unclear regarding the optimal time of testing and the optimal cut-off value of serum iPTH. PATIENTS AND METHODS: This is a prospective cohort study of 111 patients who underwent total thyroidectomy in a tertiary care endocrine surgery referral unit. Serum iPTH was measured after 20 min and 4 h of surgery. Receiver-Operator characteristic Curve (ROC) was used to find out of the best cut-off value of S. iPTH 20 min and 4 h after surgery in predicting hypocalcemia. RESULTS: Hypocalcemia was noted in 60 (54%) out of 111 subjects who underwent total thyroidectomy. The best cut-off values of Serum iPTH to predict hypocalcemia was found to be 4.28 pmol/l at 20 min post total thyroidectomy with a sensitivity and specificity of 81.7% and 51%, respectively. In addition, patients with malignancy or central lymph nodal dissection were significantly over-represented in the hypocalcemia group with serum iPTH above the threshold level of 4.28 pmol/l. Below the cut off level, parenteral calcium supplementation was required in 23% (17/74) subjects while the rate was only 5.4% (2/37) patients when serum iPTH was above the cut-off level. CONCLUSIONS: The decline of serum iPTH below a specific level after surgery has predictive value together with other factors strictly related to patient, the thyroid disease itself and surgery. The risk of development of hypocalcemia and consequent need for calcium supplementation should be evaluated by clinical assessment along with serum PTH measurement.

Effect of Tamarindus indica leaf powder on plasma concentrations of copper, zinc, and iron in fluorotic cows.

AIM: The main objective of the study was to determine the deleterious effect of fluoride on plasma trace minerals of fluorotic cattle and to evaluate the effect of Tamarindus indica leaf powder toward correction of the same. MATERIALS AND METHODS: A total of 30 cattle exhibiting chronic sign of fluorosis and 10 healthy cattle from nonfluorotic area were incorporated in this study. Fluorotic cattle were divided into three equal groups consisting of 10 cattle each. Group I from fluoride free area served as healthy control. The Group II received no treatment and served as disease control. Groups III and IV were supplemented with tamarind leaf powder at 15 g and 30 g/day with feed for 60 days. Plasma mineral status was evaluated after 60 days of treatment with double beam atomic absorption spectrophotometer. RESULTS: Statistical analysis of data revealed a significant (p<0.05) decrease in mean plasma copper (Cu) (0.344±0.007 ppm), zinc (Zn) (0.692±0.06 ppm), and iron (Fe) concentration (1.100±0.01 ppm) in fluorotic cattle in comparison to healthy cattle (0.58±0.010, 2.342±0.04, 1.406±0.04 ppm, respectively). Significant (p<0.05) increase in Cu, Zn, and Fe was recorded after supplementation of tamarind leaf powder to the fluorotic cattle. CONCLUSION: It was concluded that fluorotic cattle might be supplemented with T. indica leaf powder with feed for the correction of the decreased level of certain plasma minerals.

An Assessment of Diabetic Retinopathy and Diabetes Management System in Nepal.

BACKGROUND: Visual damage due to diabetic retinopathy is a major concern which can be reduced through appropriate coordination and cooperation between the diabetes management services and diabetic retinopathy services. The study assessed the existence, availability and accessibility of health care services for diabetes mellitus and diabetic retinopathy in Nepal. METHODS: The study was carried out from 1 April to 24 June 2015. The tool for assessment of diabetic retinopathy and diabetes management systems developed by the World Health Organization was used for the assessment of major stakeholders like endocrinologists, ophthalmologists, ophthalmic assistants, nurses involved in diabetes care, patients and human resources from Ministry of Health and Population and international non-governmental organizations dealing with eye care services in Nepal. RESULTS: Thirty-seven key stakeholders were selected for the study. Six out of fifteen ophthalmologists were unaware about the prioritization of diabetes as national health concern. The main function of diabetes association included patient education and awareness 18(48.6%), clinician education and awareness 16(43.2%). Thirteen professionals (35.1%) said that the patients were not found to be aware about diabetic patients' organizations. The information to community is provided occasionally and only through national-level media. All forms of diabetes care were funded out-of-pocket by the patients themselves. CONCLUSIONS: Coordination should be strengthened for an effective and holistic management of diabetes mellitus making diabetes care and diabetic retinopathy services more accessible. Diabetes mellitus and its complications are becoming a public health threat in Nepal.

Prospective evaluation of intra-operative quick parathyroid hormone assay as an early predictor of post thyroidectomy hypocalcaemia.

BACKGROUND: Hypocalcaemia following total thyroidectomy is a major contributing factor in delayed hospital discharge and dissuading surgeons from day care thyroidectomy. We prospectively evaluated the utility of Intra-operative serum quick parathyroid hormone level measurement twenty minutes after total thyroidectomy in predicting post-operative hypocalcemia. MATERIAL AND METHODS: Prospective longitudinal study which included patients undergoing total thyroidectomy for benign or malignant thyroid disorders at SGPGIMS, Lucknow, India from November 2013 to February 2015. Patients who received calcium prophylaxis were excluded from the study. Intraoperative serum quick PTH level measurements were done twenty minutes after resection of thyroid. Serum calcium levels were estimated preoperatively and on three consecutive post operative days. Calcium supplementation was started in patients with symptomatic hypocalcemia. RESULTS: The study included 100 patients with a mean age of 41 years, range 17-72 years. 48 patients had Euthyroid multinodular goitre, 10 patients grave's disease and 42 patients had differentiated thyroid cancer. Total thyroidectomy was performed in 88 patients, total thyroidectomy with lymph node dissection in 12 patients. Post-operatively 23% patients experienced symptomatic hypocalcemia. The IOPTH level of 9 pmol/L, twenty minutes after total thyroidectomy, had the highest sensitivity and specificity of 92% and 83% respectively in predicting post-operative hypocalcemia. CONCLUSION: Parathyroid hormone assay twenty minutes after thyroidectomy is an accurate and reliable means of predicting clinically relevant hypocalcemia. Patients with PTH values greater than 9 pmol/L twenty minutes after thyroidectomy, can be safely discharged on the same postoperative day as the probability of life threatening hypocalcemia is unlikely.

Changing microbiological profile of pathogenic bacteria in diabetic foot infections: time for a rethink on which empirical therapy to choose?

AIMS/HYPOTHESIS: We studied the bacterial aetiology and antibiotic sensitivity pattern of diabetic foot ulcers in India. METHODS: Records of 447 hospitalised patients between 1991 and 2008 were retrospectively analysed between two time periods (before and after 1999) to compare bacterial aetiology and antimicrobial sensitivity patterns. The first three consecutive cultures from the same wound during treatment were evaluated. RESULTS: Of 1,632 cultures, 66% were polymicrobial, 23% monomicrobial and 11% sterile. In the monomicrobial group, 14% (n = 228) of cultures were Gram-negative, whereas 9% (n = 147) were Gram-positive. The most common pathogens in the first culture were Pseudomonas aeruginosa (20.1%), Staphylococcus aureus (17.2%) and Escherichia coli (16.3%). Results for the third cultures showed persistence of P. aeruginosa (15.3%) and E. coli (14.2%). Gram-negative isolates dominated over Gram-positive ones (25.3% vs 15.1%, p < 0.05). Antibiotic sensitivity patterns before and after 1999 were: piperacillin-tazobactam 74% vs 66% (p < 0.005), imipenem 77% vs 85% (NS), cefoperazone-sulbactam 47% vs 44% (p < 0.005), amikacin 62% vs 78% (NS), ceftriaxone 41% vs 36% (p < 0.005), amoxicillin-clavulanate 51% vs 43% (p < 0.05) and clindamycin 43% vs 36% (p < 0.005), respectively. CONCLUSIONS/INTERPRETATION: Unlike in the West, in India Gram-negative bacteria were found to have always been dominant in the wounds of patients with diabetic foot infections. Infection with polymicrobial multidrug-resistant Gram-negative bacilli is common. The policy of empirical antimicrobial therapy at tertiary care needs to be changed.

Gedunin and photogedunin of Xylocarpus granatum show significant anti-secretory effects and protect the gastric mucosa of peptic ulcer in rats.

In the present study, the gastroprotective mechanism of Xylocarpus granatum fruit and its active constituents gedunin and photogedunin was investigated. Chloroform fraction (Fr-CHCl(3)) of X. granatum fruit was evaluated against cold restraint (CRU), aspirin (AS), alcohol (AL) and pyloric ligation (PL) induced gastric ulcer models in rats and histamine (HA) induced duodenal ulcer model in guinea pigs. Potential anti-ulcer activity of Fr-CHCl(3) was observed against CRU (58.28%), AS (67.81%), AL (84.38%), PL (65.66%) and HA (61.93%) induced ulcer models. The standard drug omeprazole (10mg/kg, p.o.) showed 68.25% protection against CRU, 57.08% against AS and 69.42% against PL model and 70.79% against HA induced duodenal ulcer. Sucralfate, another standard drug (500 mg/kg, p.o.) showed 62.72% protection in AL induced ulcer model. Fr-CHCl(3) significantly reduced free acidity (51.42%), total acidity (30.76%) and upregulated mucin secretion by 58.37% respectively. Phytochemical investigations of Fr-CHCl(3) yielded gedunin (36%), photogedunin (2%). Further, Fr-CHCl(3) and its compounds gedunin and photogedunin significantly inhibited H(+) K(+)-ATPase activity in vitro with IC(50) of 89.37, 56.86 and 66.54 microg/ml respectively as compared to the IC(50) value of omeprazole (30.24 microg/ml) confirming their anti-secretory activity. Conclusively, Fr-CHCl(3) of Xylocarpus granatum was found to possess anti-ulcerogenic activity which might be due to its anti-secretory activity and subsequent strengthening of the defensive mechanism. This study is the first of its kind to show significant anti-secretory effect of gedunin and photogedunin. Therefore it could act as a potent therapeutic agent against peptic ulcer disease.

Role of Transpupillary Thermotherapy in Central Serous Chorio-Retinopathy.

BACKGROUND: To assess the efficacy of transpupillary thermo therapy (TTT) in cases of chronic central serous chorio- retinopathy (CSCR). METHODS: A prospective evaluation was carried out on 25 cases of chronic CSCR who were subjected to TTT. Resolution of CSCR and improvement in visual acuity was noted after six weeks of therapy. RESULT: Out of 25 patients, 13 (52%) had complete success (resolution of CSCR and improvement in visual acuity > 2 lines on Snellen's chart), 10 (42%) had qualified success (resolution of CSCR but no improvement in visual acuity) and two (8%) had failure to therapy (no resolution of CSCR or improvement in visual acuity). CONCLUSION: TTT maybe a good modality in aiding resolution of subretinal fluid in cases of chronic CSCR. However, improvement in visual function is dependent upon integrity of photo receptor layer of retina which is not influenced by this modality. A controlled study could be undertaken to compare outcome of TTT with conservative management in cases of early CSCR such that deleterious effects of chronic CSCR on the retinal photoreceptor layer are avoided.

Surgical treatment of sternal metastases from thyroid carcinoma: report of two cases.

Radioiodine therapy is currently the treatment of choice for metastasizing differentiated thyroid cancer (DTC); however, skeletal metastases are resistant to this form of therapy. The surgical removal of distant metastases from DTC offers the best chance for prolonged survival and improved quality of life. Furthermore, the surgical removal of a resectable skeletal metastasis can be a valuable complement to radioiodine therapy. This report describes two cases of sternal metastases from thyroid carcinoma that were managed successfully by surgery involving partial excision of the sternum followed by reconstruction of the chest wall with Marlex mesh. Both patients recovered uneventfully. Sternal resection with Marlex mesh reconstruction of the chest wall defect proved a simple and effective method for managing sternal metastasis. Thus, the surgical resection of distant bony metastases in patients with DTC is recommended as it can be curative, provide symptomatic palliation, or allow for more effective radioiodine treatment.

A multicentric study with arteether in patients of uncomplicated falciparum malaria.

Two hundred and sixty seven patients of uncomplicated P. falciparum malaria completed study in a multicentric phase III clinical trial of Arteether. Arteether was given intramuscularly in a dose of 150 mg daily for three consecutive days. Each patient was followed upto 28 days of alpha, beta arteether therapy. The cure rate was 97% with fever clearance time between 1-7 days (24-168 hours) and parasite clearance time between 1-3 days (24-72 hours). Parasite reappearance rate was found to be 3% and reported at only three of the centres. Following the treatment no adverse effect was observed on haematological, biochemical and vital clinical parameters.

Multicentric clinical trials for safety and efficacy evaluation of alpha;beta arteether in complicated P. falciparum malaria.

OBJECTIVE: To evaluate efficacy of alpha;beta arteether in patients of P. falciparum malaria presenting with complications was undertaken in a multicentric clinical trial. METHOD: Each patient who consented to undergo clinical trial with parenteral Arteether was treated with a fixed dose schedule of Arteether given intramuscularly in a dose of 150 mg once a day on three consecutive days. Every patient was followed upto 28 days with clinical, haematological and parasitological monitoring every day upto one week and thereafter at 14, 21 and 28 days. The response was assessed in terms of fever clearance time, parasite clearance time, cure rate and parasite reappearance rate. RESULTS: A total of 211 patients of P. falciparum malaria were included in the study from four centres (Bhilai, Guwahati, Jamshedpur and Rourkela). Results of this study showed that fever clearance time ranged between 24-168 hours, parasite clearance time ranged between 24-120 hours and overall mortality ranged between 4-8.5%. Out of 211, only 14 patients expired during the study, of these, 10 patients expired within first two days i.e. before completing the three day schedule of arteether therapy. Tolerability to arteether injection was good in all these patients and no untoward effects were experienced or reported during the study. Overall cure rate observed in these studies was 93%. CONCLUSION: This study shows a rapid parasite and fever clearance in patients of complicated P. falciparum malaria.

Avirulent mutants of Macrophomina phaseolina and Aspergillus fumigatus initiate infection in Phaseolus mungo in the presence of phaseolinone; levamisole gives protection.

To evaluate the role of phaseolinone, a phytotoxin produced by Macrophomina phaseolina, in disease initiation, three nontoxigenic avirulent mutants of the fungus were generated by UV-mutagenesis. Two of them were able to initiate infection in germinating Phaseolus mungo seeds only in the presence of phaseolinone. The minimum dose of phaseoli-none required for infection in 30% seedlings was 2 5 mg/ml. A human pathogen, Aspergillus fumigatus was also able to infect germinating seeds of P. mungo in the presence of 5 mg/ml concentration of phaseolinone. Phaseolinone seemed to facilitate infection by A. fumigatus, which is not normally phytopathogenic, by reducing the immunity of germinating seedlings in a nonspecific way. Levamisole, a non-specific immunopotentiator gave protection against infection induced by A. fumigatus at an optimum dose of 50 mg/ml. Sodium malonate prevented the effects of levamisole.

alpha, beta-Arteether for the treatment of complicated falciparum malaria.

alpha, beta-Arteether is an ethyl ether derivative of artemisinin which is an efficient schizontocidal drug in mild falciparum malaria. The present study reports the efficacy of the drug in severe falciparum malaria. Fifty patients with severe falciparum malaria were given intramuscular arteether, 150 mg, once daily on 3 consecutive days. The median fever clearance time was 72 h (range 12-120 h) and the median parasite clearance time was 2 d (range 1-4 d). Rapid recovery from coma was observed in cerebral malaria patients (after a median of 18 h, range 6-72 h). The recovery from other complications was also faster and complete. Two patients died; both had cerebral malaria and haemolytic jaundice, one had respiratory distress needing ventilatory support and the other had severe anaemia. Recrudescence within 28 d was observed in 7 patients. Drug toxicity or significant side effects were not noticed in any patient.

Delivery practices in west Uttar Pradesh.

The present study has been planned to identify healthy and unhealthy delivery practices in rural U.P. specially with reference to five cleans recommended under national C.S.S.M. programme. A total 120 women who had delivered in recent past were interviewed. Only in 3.1 percent deliveries, proper washing of floor was done, in 43 percent deliveries the cord cutting instrument was not sterilized and in about 65 percent deliveries mustard oil and ghee was used as first cord applicant.

PIP: Infant mortality remains high in the northern states of India. Neonatal tetanus is one of the important causes of early infant death in the region. The authors identified healthy and unhealthy delivery practices in rural West Uttar Pradesh based upon interview data from 120 women who recently delivered at home. 98 of the deliveries occurred in the household living room, while the remaining 22 were conducted elsewhere in the home. The floor was properly washed in only 3.1% of deliveries, the cord cutting instrument was not sterilized in 43% of deliveries, and mustard oil and deshi ghee were used as first cord applicants in approximately 65% of deliveries. Hygienic delivery practices and settings are not commonly used in this study area. Trained birth attendants were no better aware of cleanliness in delivery practice than untrained birth attendants. Community awareness was also lacking. It is recommended that birth attendants have periodic refresher training and a viable monitoring system of birth attendant-conducted deliveries be established.

Effectiveness of alpha,beta-arteether in acute falciparum malaria.

With the emergence of widespread chloroquine resistance and a world-wide scarcity of quinine, a search for newer antimalarial drugs has become imperative. Different derivatives of qinghaosu have been successfully tried. alpha,beta-Arteether, an ethyl derivative of qinghaosu, was administered to 51 patients with Plasmodium falciparum malaria, in a dose of 150 mg intramuscularly once a day on 3 consecutive days. Complete parasite clearance from the peripheral blood was observed in 80% of the patients at 48 h and in 98% at 72 h. The median parasite clearance time was 2 d (range 1-4 d). 65% of the patients became afebrile within 48 h and 81% by 72 h. The mean fever clearance time was 52.04 h (standard deviation 27.09). No side effect was seen. Patients were followed-up for 4 weeks; 7 were readmitted with P. falciparum infection but it could not be ascertained definitely whether these cases were reinfections or recrudescences. alpha-beta Arteether was a safe, effective and convenient drug for treating P. falciparum malaria. This is the first clinical study with arteether in falciparum malaria.

Role of ayurveda in planning strategies of "aids": control in India.

"AIDS" is a new clinical entity identified around 1980. There is a marked increase in the incidence of the disease in the USA. Since our country has a lot of interaction around the world, including the areas of occurrence of the disease and also that the risk factors and high risk group exist in our country there is a scare about the syndrome.

Role of ayurveda and yoga to overcome aging.

The changes in the body with aging are various. They can be avoided by judicious use of the knowledge of Aha Vihara and Carya described in the Ayurvedic texts alongwith certain yogic practices with are minutely discussed here.